1 00:00:01,440 --> 00:00:04,240 Speaker 1: Welcome to Stuff You Should Know, a production of I 2 00:00:04,360 --> 00:00:13,200 Speaker 1: Heart Radio. Hey, and welcome to the podcast. I'm Josh, 3 00:00:13,240 --> 00:00:15,600 Speaker 1: and there's Chuck and Jerry's lurking around here like a 4 00:00:15,640 --> 00:00:18,799 Speaker 1: creeper weirdo who takes pictures of people without their permission. 5 00:00:19,200 --> 00:00:23,079 Speaker 1: And this is stuff you should know. I like that. 6 00:00:24,000 --> 00:00:27,680 Speaker 1: The joke is so nice. I said it twice. Uh 7 00:00:27,720 --> 00:00:30,240 Speaker 1: So we should issue a trigger warning before this episode 8 00:00:30,320 --> 00:00:34,840 Speaker 1: because we are talking about bariatric surgery, which some people 9 00:00:34,920 --> 00:00:38,000 Speaker 1: refer to as weight loss surgery, and the topic of 10 00:00:38,040 --> 00:00:42,120 Speaker 1: food and weight and weight loss and obesity and weight 11 00:00:42,159 --> 00:00:45,680 Speaker 1: loss surgery could be very triggering for people. So if 12 00:00:45,680 --> 00:00:47,920 Speaker 1: you want to listen to this one, great, we're gonna 13 00:00:48,000 --> 00:00:50,279 Speaker 1: just break it down like we usually do. But if 14 00:00:50,320 --> 00:00:51,680 Speaker 1: it's something that you don't want to listen to, we 15 00:00:51,720 --> 00:00:55,840 Speaker 1: totally understand. Yeah. I mean, after researching this, I totally 16 00:00:55,880 --> 00:00:59,560 Speaker 1: get why, like a fat positive or somebody who would 17 00:00:59,600 --> 00:01:02,520 Speaker 1: be triggered by talk of that could be upset by 18 00:01:02,520 --> 00:01:06,720 Speaker 1: it because there's a there's a pretty substantial argument to 19 00:01:06,760 --> 00:01:10,800 Speaker 1: be made that bariatric surgery is conducted just to make 20 00:01:11,319 --> 00:01:17,119 Speaker 1: obese and overweight people acceptable to society. That that's basically 21 00:01:17,160 --> 00:01:20,559 Speaker 1: the upshot of of why people get this surgery done. 22 00:01:20,760 --> 00:01:23,480 Speaker 1: That's not necessarily true for everybody, but there's a whole 23 00:01:23,520 --> 00:01:25,960 Speaker 1: there's a whole school of thought that says, you know, 24 00:01:26,560 --> 00:01:29,560 Speaker 1: this is this is a medical form of fat shaming 25 00:01:30,200 --> 00:01:33,479 Speaker 1: for some people at least. Yeah. And there's another school 26 00:01:33,480 --> 00:01:41,119 Speaker 1: of thought that it's uh, you know, uh, disease solving surgery. Uh. 27 00:01:41,120 --> 00:01:44,080 Speaker 1: And the evidence plays out that it really does help 28 00:01:44,120 --> 00:01:48,960 Speaker 1: with things like diabetes and hypertension and can be very successful. 29 00:01:49,240 --> 00:01:51,760 Speaker 1: The reason I thought of this to begin with was 30 00:01:52,240 --> 00:01:56,160 Speaker 1: I saw a Box article called We're barely using the 31 00:01:56,200 --> 00:02:00,080 Speaker 1: best tool we have to fight obesity, uh. And this 32 00:02:00,200 --> 00:02:03,320 Speaker 1: sort of cruxt of that article, which we'll talk about here, 33 00:02:03,440 --> 00:02:06,840 Speaker 1: is that only about one percent of people who qualify 34 00:02:06,920 --> 00:02:10,560 Speaker 1: for bariatric surgery use it. And the Vox article was 35 00:02:10,680 --> 00:02:13,720 Speaker 1: all behind it and basically said, we have this great tool, 36 00:02:14,480 --> 00:02:18,080 Speaker 1: uh for people that cannot seem to get down to 37 00:02:18,120 --> 00:02:20,880 Speaker 1: what is a healthy weight for them who are suffering 38 00:02:20,880 --> 00:02:24,240 Speaker 1: from hypertension diabetes, And they were saying, like, people should 39 00:02:24,320 --> 00:02:26,280 Speaker 1: use the surgery more. And there's a lot of reasons 40 00:02:26,520 --> 00:02:29,280 Speaker 1: why people don't, which we're also going to talk about. Yeah, 41 00:02:29,280 --> 00:02:31,400 Speaker 1: I mean, there's one thing that everybody can agree on, 42 00:02:32,240 --> 00:02:36,679 Speaker 1: like bariatric surgery works for weight loss to to it's 43 00:02:36,680 --> 00:02:38,680 Speaker 1: like a spectrum of how much it works, but it 44 00:02:38,800 --> 00:02:43,200 Speaker 1: definitely works. There's substantial results once it happens, and understandably so, 45 00:02:43,280 --> 00:02:48,880 Speaker 1: because it is a radical surgical procedure where you're like 46 00:02:49,280 --> 00:02:53,359 Speaker 1: really profoundly altering your internal anatomy so that you can, 47 00:02:53,400 --> 00:02:56,200 Speaker 1: in some cases except less food, in some cases digest 48 00:02:56,400 --> 00:02:58,880 Speaker 1: food less or have less of a chance to digest food. 49 00:02:59,040 --> 00:03:03,600 Speaker 1: And we should point out we're talking about modern bariatric 50 00:03:03,680 --> 00:03:08,120 Speaker 1: surgery because even ten years ago, results were wildly different. 51 00:03:08,720 --> 00:03:12,880 Speaker 1: The preferred surgeries were wildly different. And uh, they've come 52 00:03:12,919 --> 00:03:15,720 Speaker 1: a long long way in the past even ten years. Yeah, 53 00:03:15,720 --> 00:03:17,880 Speaker 1: it definitely has hit its stride in the last ten 54 00:03:17,960 --> 00:03:21,920 Speaker 1: years for sure. Um, but there's uh, as far as 55 00:03:21,960 --> 00:03:24,040 Speaker 1: the history of this whole idea goes, it's not a 56 00:03:24,080 --> 00:03:28,320 Speaker 1: new concept. Um. It goes back at least to the 57 00:03:28,440 --> 00:03:31,639 Speaker 1: end of the nineteenth century. Some people say it goes 58 00:03:31,680 --> 00:03:35,280 Speaker 1: back as far as the tenth century, which is amazing 59 00:03:35,320 --> 00:03:38,000 Speaker 1: to think about. And you know what, Olivia helped us 60 00:03:38,000 --> 00:03:40,600 Speaker 1: with this, and I had a feeling when I said, hey, 61 00:03:40,720 --> 00:03:42,520 Speaker 1: let's cover the history I was like, there's got to 62 00:03:42,560 --> 00:03:45,600 Speaker 1: be some you know, hundreds and hundreds of year old 63 00:03:46,000 --> 00:03:49,360 Speaker 1: procedure that somebody did. And if you believe the story, 64 00:03:49,400 --> 00:03:51,440 Speaker 1: in the tenth century, there was a King Sancho of 65 00:03:51,520 --> 00:03:55,280 Speaker 1: Leon and Sancho was so big. And this is when 66 00:03:56,440 --> 00:03:59,800 Speaker 1: Ed McMahon chimes in, how big was he? He was, 67 00:04:00,000 --> 00:04:02,560 Speaker 1: oh big that he couldn't ride a horse or walk 68 00:04:03,680 --> 00:04:08,920 Speaker 1: ouch as the story. As the story goes, so the 69 00:04:09,040 --> 00:04:13,120 Speaker 1: doctor did the most basic form of weight loss surgery 70 00:04:13,120 --> 00:04:16,400 Speaker 1: at the time, which was the suture King Sancho's lips 71 00:04:16,720 --> 00:04:19,920 Speaker 1: shut so that King Sancho could only ingest a liquid 72 00:04:19,960 --> 00:04:23,680 Speaker 1: diet and apparently lost about half his weight and got 73 00:04:23,720 --> 00:04:28,200 Speaker 1: the thrown back. So that's a nuts so story. I 74 00:04:28,279 --> 00:04:35,840 Speaker 1: find something else that comes later chuck even more nuts so. No. Um, 75 00:04:35,880 --> 00:04:40,440 Speaker 1: In the twenty one century, there was a push um 76 00:04:40,560 --> 00:04:45,200 Speaker 1: to basically reintroduce jaw wiring. Oh yeah, yeah, it's so 77 00:04:45,400 --> 00:04:47,640 Speaker 1: this whole thing with King Sancho, one of the original 78 00:04:47,720 --> 00:04:51,560 Speaker 1: kings of Leon. Um Like it got picked up like 79 00:04:51,600 --> 00:04:55,000 Speaker 1: a thousand or so years later. Um, even though it's 80 00:04:55,080 --> 00:04:57,400 Speaker 1: been shown nut to work, as we'll see, But the 81 00:04:57,440 --> 00:05:01,320 Speaker 1: whole like modern bariatric surgery um actually was born in 82 00:05:01,360 --> 00:05:04,760 Speaker 1: the nineteenth century out of um uh the same kinds 83 00:05:04,760 --> 00:05:07,960 Speaker 1: of procedures, but for a totally different purpose. UM. A 84 00:05:08,000 --> 00:05:11,120 Speaker 1: guy named Caesar rue came up with a surgical technique 85 00:05:11,120 --> 00:05:15,160 Speaker 1: called the ruin why and UM. It was used in 86 00:05:15,200 --> 00:05:18,400 Speaker 1: case you had like some sort of like um bowel 87 00:05:18,560 --> 00:05:22,599 Speaker 1: or gastric obstruction. He figured out how to bypass it 88 00:05:23,000 --> 00:05:26,760 Speaker 1: um and and connect your stomach to a different part 89 00:05:26,800 --> 00:05:29,480 Speaker 1: of your intestine to get around the obstruction and yet 90 00:05:29,480 --> 00:05:32,839 Speaker 1: you would still have functioning parts UM. And that was 91 00:05:32,880 --> 00:05:37,120 Speaker 1: where the idea of um of gastric bypass surgery came from, 92 00:05:37,160 --> 00:05:39,120 Speaker 1: or the name of it, yeah, which all the way 93 00:05:39,160 --> 00:05:41,159 Speaker 1: back in nine two, which is really hard to believe, 94 00:05:41,240 --> 00:05:44,720 Speaker 1: but it uh. They called it ruin why because I 95 00:05:44,760 --> 00:05:48,360 Speaker 1: believe it's sort of forms y shape when you're finished. 96 00:05:48,520 --> 00:05:56,719 Speaker 1: And that was about mortality rate initially in no surprise, 97 00:05:56,839 --> 00:05:59,359 Speaker 1: but they got that down to about eleven, which is 98 00:05:59,400 --> 00:06:02,840 Speaker 1: really great for the time period, I think. And then 99 00:06:03,400 --> 00:06:06,120 Speaker 1: you know, things kind of went along as people were 100 00:06:06,560 --> 00:06:11,520 Speaker 1: experimenting with those obstruction UH surgeries. There were doctors that 101 00:06:11,680 --> 00:06:14,200 Speaker 1: started to say, hey, wait a minute, we now have 102 00:06:14,240 --> 00:06:17,240 Speaker 1: a thing called a scale and humans we don't just 103 00:06:17,279 --> 00:06:20,320 Speaker 1: need to put grain on it. Humans can stand on 104 00:06:20,400 --> 00:06:23,800 Speaker 1: it so we know how much we weigh. And everyone went, 105 00:06:23,960 --> 00:06:26,960 Speaker 1: what hey, that's a great idea. I can't wait to 106 00:06:26,960 --> 00:06:30,200 Speaker 1: weigh myself every day, is what everyone said. I haven't 107 00:06:30,200 --> 00:06:31,720 Speaker 1: weighed myself in a long time. I kind of quit 108 00:06:32,360 --> 00:06:36,120 Speaker 1: me either, me too, But hard to believe, but yes, 109 00:06:36,279 --> 00:06:38,920 Speaker 1: humans started weighing themselves, and all of a sudden in 110 00:06:38,920 --> 00:06:43,000 Speaker 1: the nineteen twenties and thirties, doctors started in patients started 111 00:06:43,000 --> 00:06:46,360 Speaker 1: paying attention to their you know, to their little literal weight, 112 00:06:46,440 --> 00:06:48,400 Speaker 1: not just like how they looked and how they felt 113 00:06:49,160 --> 00:06:53,760 Speaker 1: right weight gain and um being overweight and I'm using 114 00:06:53,800 --> 00:06:57,320 Speaker 1: scare quotes here, um or obese again, scare scare quotes. 115 00:06:57,440 --> 00:07:01,920 Speaker 1: Um became medicalized at point, like it became a medical issue, 116 00:07:01,920 --> 00:07:05,599 Speaker 1: a problem to be treated. And it's just that whole idea, 117 00:07:05,600 --> 00:07:08,080 Speaker 1: and that whole concept has has taken off since then. 118 00:07:08,120 --> 00:07:12,080 Speaker 1: It's just so so fully ingrained in our our society 119 00:07:12,120 --> 00:07:14,640 Speaker 1: that it's really interesting to think, like it's only been 120 00:07:14,640 --> 00:07:18,040 Speaker 1: around for maybe a hundred or so years. But um, 121 00:07:18,160 --> 00:07:22,680 Speaker 1: they basically would give you anything that you wanted to 122 00:07:22,840 --> 00:07:27,720 Speaker 1: lose weight, like amphetamines, laxatives, UM, just anything. You just 123 00:07:27,720 --> 00:07:30,080 Speaker 1: go to the doctor and he give you whatever. UM. 124 00:07:30,120 --> 00:07:34,360 Speaker 1: But it wasn't until the nineteen forties that that whole 125 00:07:34,840 --> 00:07:39,800 Speaker 1: idea of medicalizing um being overweight, uh like, really kind 126 00:07:39,840 --> 00:07:43,040 Speaker 1: of spread into society at large, when the insurance companies 127 00:07:43,080 --> 00:07:45,720 Speaker 1: got involved. Yeah, and I should point out to you 128 00:07:45,720 --> 00:07:48,160 Speaker 1: you're using scare quotes when you say things like overweight 129 00:07:48,200 --> 00:07:52,160 Speaker 1: and obese because there is so much individual variation in 130 00:07:53,160 --> 00:07:55,600 Speaker 1: in body weight and how people carry it and how 131 00:07:55,640 --> 00:07:59,880 Speaker 1: healthy they are. And we understand this, I mean, we 132 00:08:00,080 --> 00:08:02,640 Speaker 1: sort of understand this now as far as people accepting it, 133 00:08:02,680 --> 00:08:05,040 Speaker 1: but there's still not a lot of acceptance around it. 134 00:08:05,560 --> 00:08:07,920 Speaker 1: That's why when you calculate something like a b M 135 00:08:07,960 --> 00:08:10,880 Speaker 1: I that is for you know, to judge a population 136 00:08:10,920 --> 00:08:14,400 Speaker 1: that does not take into an account take into account 137 00:08:14,400 --> 00:08:18,200 Speaker 1: of an individual or their muscle mass or you know, 138 00:08:18,560 --> 00:08:21,720 Speaker 1: their body shape. So they kind of throw these tags 139 00:08:22,720 --> 00:08:25,440 Speaker 1: on overweight and obese and b M I that are 140 00:08:27,120 --> 00:08:29,200 Speaker 1: useful in a certain sense, but also not useful in 141 00:08:29,200 --> 00:08:32,199 Speaker 1: a certain sense. Yeah. And the b M I scale 142 00:08:32,280 --> 00:08:34,560 Speaker 1: was invented in the nineteenth century by a guy named 143 00:08:34,559 --> 00:08:39,120 Speaker 1: Adolf quite Alet. He was a sociologist and he based 144 00:08:39,240 --> 00:08:44,800 Speaker 1: exclusively on white Western Europeans. So in a way, you 145 00:08:44,840 --> 00:08:47,240 Speaker 1: could say the b m I scale has created the 146 00:08:47,360 --> 00:08:52,040 Speaker 1: ideal body form is a average sized or whatever the 147 00:08:52,040 --> 00:08:55,120 Speaker 1: b m I says, the average size white European. The 148 00:08:55,200 --> 00:08:58,000 Speaker 1: problem is that's that's a problem in and of itself, 149 00:08:58,040 --> 00:09:00,240 Speaker 1: because you now have a compartment that you're trying to 150 00:09:00,240 --> 00:09:02,679 Speaker 1: shove everybody in regardless, and if you're not in that 151 00:09:02,720 --> 00:09:06,800 Speaker 1: compartment that you're supposed to be in, you have a problem, um, 152 00:09:07,040 --> 00:09:10,600 Speaker 1: a medical problem even maybe even a life threatening problem. Um. 153 00:09:10,640 --> 00:09:14,120 Speaker 1: But more than that, if you're not white and Western European, 154 00:09:14,760 --> 00:09:17,199 Speaker 1: that scales shouldn't really apply to you. But that hasn't 155 00:09:17,360 --> 00:09:21,959 Speaker 1: kept humanity or people from plugging all of humanity into 156 00:09:22,040 --> 00:09:23,920 Speaker 1: that same b m I scale. So there's a lot 157 00:09:23,920 --> 00:09:27,959 Speaker 1: of questions about the bm I scale itself, and especially 158 00:09:28,040 --> 00:09:31,240 Speaker 1: in recent years. Yeah, and I hope everyone understands when 159 00:09:31,240 --> 00:09:35,959 Speaker 1: we use those terms. All of this goes into that. UM. 160 00:09:36,160 --> 00:09:39,719 Speaker 1: As doctors were looking at uh, you know, still kind 161 00:09:39,720 --> 00:09:43,280 Speaker 1: of performing these surgeries, they noticed that, hey, you can 162 00:09:43,320 --> 00:09:46,080 Speaker 1: lose weight, you know the initial ruin why when you 163 00:09:46,120 --> 00:09:48,440 Speaker 1: had an obstruction, They were like, wait, this is good 164 00:09:48,440 --> 00:09:52,200 Speaker 1: for weight loss? Too, because quite simply, your stomach is 165 00:09:52,240 --> 00:09:55,439 Speaker 1: smaller and your body is not absorbing. You can't eat 166 00:09:55,440 --> 00:09:58,720 Speaker 1: as much and it's not absorbing as many nutrients and 167 00:09:58,920 --> 00:10:04,080 Speaker 1: in you, they believe. The very first real deal weight 168 00:10:04,120 --> 00:10:08,360 Speaker 1: loss surgery occurred again from a Swedish surgeon named Victor 169 00:10:09,000 --> 00:10:13,439 Speaker 1: ein Rickson, when Victor removed a hundred hundred three centimeters 170 00:10:13,800 --> 00:10:15,800 Speaker 1: of small intestine from a woman, a thirty two year 171 00:10:15,800 --> 00:10:19,360 Speaker 1: old woman who didn't lose that much weight, but supposedly 172 00:10:19,440 --> 00:10:23,199 Speaker 1: it improved her life quality. Yeah, and just the next 173 00:10:23,320 --> 00:10:27,920 Speaker 1: year UH an American named Dr Richard Varco created a 174 00:10:28,200 --> 00:10:33,880 Speaker 1: slightly altered, ruined why procedure called the j juno ilio bypass. 175 00:10:34,720 --> 00:10:38,280 Speaker 1: I practiced that so many times. My brain just says, Nope, 176 00:10:38,320 --> 00:10:41,080 Speaker 1: you're never gonna get it right. The first time, I 177 00:10:41,080 --> 00:10:43,640 Speaker 1: think that was probably close. It was close, but there 178 00:10:43,679 --> 00:10:45,920 Speaker 1: was like a hitch and a stumble in there too. 179 00:10:46,320 --> 00:10:49,200 Speaker 1: Ju Juna lial is what I would say, oh, showing 180 00:10:49,240 --> 00:10:53,160 Speaker 1: off a but then may not be right either, and 181 00:10:53,200 --> 00:10:56,120 Speaker 1: that comes from I'm sorry, that's that's what the first time. 182 00:10:56,160 --> 00:10:59,600 Speaker 1: They called it bariatric surgery, right, yes, And bariatric is 183 00:10:59,640 --> 00:11:04,280 Speaker 1: from the Greek for weight or heavy UM. So they said, 184 00:11:04,320 --> 00:11:06,960 Speaker 1: I guess this is surgery for heavy people. Maybe I'm 185 00:11:06,960 --> 00:11:10,440 Speaker 1: not sure, but that's where that's that's about. The fifties 186 00:11:10,480 --> 00:11:13,839 Speaker 1: is about when that that name became applied to it UM. 187 00:11:13,920 --> 00:11:17,720 Speaker 1: And then in the sixties UM they were starting to 188 00:11:17,720 --> 00:11:20,800 Speaker 1: do studies and experimentation with it. And there was a 189 00:11:20,800 --> 00:11:24,840 Speaker 1: study that found that UM a temporary procedure where you 190 00:11:24,840 --> 00:11:28,280 Speaker 1: would have like your stomach moved to a different part 191 00:11:28,280 --> 00:11:32,200 Speaker 1: of your small intestine. Temporarily you lose the weight and 192 00:11:32,200 --> 00:11:35,120 Speaker 1: then they go reverse the procedure. They found that patients 193 00:11:35,200 --> 00:11:38,600 Speaker 1: just basically gained the weight back after the procedure was reversed. 194 00:11:38,840 --> 00:11:41,600 Speaker 1: And at that point in the early sixties, these surgeries 195 00:11:41,600 --> 00:11:45,400 Speaker 1: started to become permanent in nature pretty much across the board. Yeah, 196 00:11:45,400 --> 00:11:48,320 Speaker 1: you know, that was my first surprise in this research. 197 00:11:49,559 --> 00:11:53,680 Speaker 1: I thought, even modern bariatric bypasses and stuff, I thought 198 00:11:53,760 --> 00:11:57,360 Speaker 1: that was all a temporary thing, and that like, you 199 00:11:57,440 --> 00:11:59,720 Speaker 1: don't live with an egg sized stomach for the rest 200 00:11:59,720 --> 00:12:02,360 Speaker 1: of your life, and that's not true. You live with 201 00:12:02,400 --> 00:12:05,160 Speaker 1: an excized stomach the rest of your life. Yeah. They 202 00:12:05,200 --> 00:12:08,440 Speaker 1: as we'll see, they remove a significant portion of your 203 00:12:08,480 --> 00:12:11,320 Speaker 1: stomach in either one of the surgeries that you get, 204 00:12:11,800 --> 00:12:14,760 Speaker 1: and that when they do that, that's that's irreversible, that 205 00:12:14,840 --> 00:12:17,560 Speaker 1: part of your stomach is gone. What's amazing to me 206 00:12:17,679 --> 00:12:19,920 Speaker 1: is that they've gotten good enough at it that it 207 00:12:20,000 --> 00:12:24,959 Speaker 1: has tremendous results, and the complications have kind of died 208 00:12:25,000 --> 00:12:28,280 Speaker 1: down over the years to where the risk of death 209 00:12:28,360 --> 00:12:32,400 Speaker 1: is now down to about point one percent. Uh. In 210 00:12:32,440 --> 00:12:37,360 Speaker 1: the twenties, it's gotten that low, but just around two thousand, 211 00:12:37,440 --> 00:12:39,480 Speaker 1: twenty years ago, it was still up at one percent, 212 00:12:39,600 --> 00:12:42,560 Speaker 1: which is really high for a surgical procedure in the 213 00:12:42,559 --> 00:12:46,679 Speaker 1: Western world in the twentieth century, but they've they've whittled 214 00:12:46,679 --> 00:12:49,640 Speaker 1: it down ten times lower than it was twenty years 215 00:12:49,640 --> 00:12:53,319 Speaker 1: before because they started using lap of scopic surgery. That's right. 216 00:12:53,360 --> 00:12:57,480 Speaker 1: Olivia points out that point one percent is less than 217 00:12:57,520 --> 00:13:00,400 Speaker 1: knee replacement surgery, just to kind of put that, you know, 218 00:13:00,480 --> 00:13:03,280 Speaker 1: to frame that. Yeah, and also I want to correct myself. 219 00:13:03,320 --> 00:13:05,000 Speaker 1: It wasn't in the twenty first century. It was in 220 00:13:05,040 --> 00:13:07,360 Speaker 1: the mid twentieth century that they tried to bring back 221 00:13:07,400 --> 00:13:10,320 Speaker 1: jaw wiring, but it just doesn't work, that's right. And 222 00:13:10,559 --> 00:13:15,800 Speaker 1: as a result of the success rate and the obviously 223 00:13:15,840 --> 00:13:19,439 Speaker 1: whittling that death rate down to point one. UM surgeries 224 00:13:19,520 --> 00:13:24,000 Speaker 1: now are crunching up towards a three hundred thousand per year. 225 00:13:24,040 --> 00:13:27,240 Speaker 1: I think two hundred and fifty six thousand was the 226 00:13:27,320 --> 00:13:29,400 Speaker 1: last year that we have a number four, and that 227 00:13:29,440 --> 00:13:33,600 Speaker 1: was in twenty nineteen, as opposed to about twenty thousand 228 00:13:33,600 --> 00:13:35,240 Speaker 1: a year in the nineties and about a hundred and 229 00:13:35,320 --> 00:13:40,559 Speaker 1: fifty thousand and change in the mid two thousand's because 230 00:13:40,559 --> 00:13:43,240 Speaker 1: they said, hey, everybody, we don't killed nearly as many 231 00:13:43,320 --> 00:13:45,160 Speaker 1: of you as we used to come and get it. 232 00:13:46,360 --> 00:13:48,520 Speaker 1: Should we take a break? Sure? All right, that was 233 00:13:48,559 --> 00:13:50,559 Speaker 1: a good setup. So let's take a break and we'll 234 00:13:50,600 --> 00:14:17,760 Speaker 1: be right back. Okay, Chuck, So we're back, and I 235 00:14:17,800 --> 00:14:20,560 Speaker 1: think it's high time that we actually talked about how 236 00:14:20,720 --> 00:14:24,320 Speaker 1: a bariatric surgery goes UM. And there's a couple of 237 00:14:24,360 --> 00:14:27,840 Speaker 1: different ways you can go UM. Some are more popular 238 00:14:27,880 --> 00:14:29,760 Speaker 1: than others. It seems like one that used to be 239 00:14:29,800 --> 00:14:33,280 Speaker 1: more popular than ruin why the bypass has become less 240 00:14:33,320 --> 00:14:37,160 Speaker 1: popular in favor of one called sleeve. Guests Guests direct 241 00:14:37,200 --> 00:14:39,640 Speaker 1: to me, See, I can never get it. The first 242 00:14:39,680 --> 00:14:43,240 Speaker 1: time you want to say gastronomy, I did. I wanted 243 00:14:43,280 --> 00:14:47,880 Speaker 1: to say gastro pub Uh yeah, this is easily the 244 00:14:47,920 --> 00:14:51,800 Speaker 1: most common um performed today. This is the one that's 245 00:14:51,880 --> 00:14:54,960 Speaker 1: very very popular right now. They remove about eight of 246 00:14:55,000 --> 00:14:59,560 Speaker 1: your stomach and basically the stomach, instead of being a 247 00:14:59,680 --> 00:15:03,400 Speaker 1: large pouch, becomes a narrow sleeve. That's why it's called sleeve. 248 00:15:03,720 --> 00:15:07,560 Speaker 1: Gets struck to me, and it's it's very very simple, 249 00:15:07,680 --> 00:15:10,880 Speaker 1: and that you have a much, much, much much smaller stomach, 250 00:15:11,400 --> 00:15:13,520 Speaker 1: so you can't eat as much. You will feel full 251 00:15:13,560 --> 00:15:17,440 Speaker 1: more quickly. But what also happens is and I'm not 252 00:15:17,480 --> 00:15:19,320 Speaker 1: sure if they had a hunch this would happen, or 253 00:15:19,320 --> 00:15:22,000 Speaker 1: if they knew this would happen, but it also tricks 254 00:15:22,040 --> 00:15:25,800 Speaker 1: the body into releasing a few of those hormones that 255 00:15:25,880 --> 00:15:29,240 Speaker 1: say that you're hungry. So it's not like, oh, I'm 256 00:15:29,280 --> 00:15:31,680 Speaker 1: still hungry all the time. Like you just have a 257 00:15:31,680 --> 00:15:35,680 Speaker 1: smaller stomach. You eat less and you're satisfied. Yeah, you 258 00:15:35,720 --> 00:15:38,720 Speaker 1: eat less and you have the desire to eat less 259 00:15:38,760 --> 00:15:41,160 Speaker 1: on top of that. So, I mean you can imagine 260 00:15:41,160 --> 00:15:44,240 Speaker 1: that this has tremendous results. And I think that they 261 00:15:44,280 --> 00:15:47,000 Speaker 1: did know that that hormone um effect was going to 262 00:15:47,120 --> 00:15:50,400 Speaker 1: happen because they specifically remove a part of the stomach 263 00:15:50,440 --> 00:15:53,920 Speaker 1: called the fundest and that's the portion that expands when 264 00:15:53,920 --> 00:15:56,400 Speaker 1: you eat a lot of food, So your stomach can't 265 00:15:56,440 --> 00:15:58,760 Speaker 1: expand when you eat food. You got to keep that 266 00:15:58,840 --> 00:16:01,800 Speaker 1: in mind. And then also the funnest is where grellan 267 00:16:02,160 --> 00:16:05,400 Speaker 1: is largely made, and that's that hunger hormone. So you're 268 00:16:05,440 --> 00:16:09,120 Speaker 1: producing less grillan and you just can't physically fit that 269 00:16:09,200 --> 00:16:13,920 Speaker 1: much food into your stomach anymore. Right, And like I said, 270 00:16:13,920 --> 00:16:16,600 Speaker 1: it's the most popular form today. I think in the 271 00:16:16,640 --> 00:16:20,880 Speaker 1: mid two thousand's it was about eight bariatric surgeries. Now 272 00:16:21,280 --> 00:16:23,840 Speaker 1: or in twenty nineteen it was it's even more than 273 00:16:23,880 --> 00:16:27,240 Speaker 1: that two. I just don't have the most recent number. 274 00:16:27,280 --> 00:16:30,680 Speaker 1: I was, um, I just got back from vacation in 275 00:16:30,760 --> 00:16:34,640 Speaker 1: Mexico and one of the two families that we kind 276 00:16:34,640 --> 00:16:36,600 Speaker 1: of hung out with him buddied up with. I was 277 00:16:36,680 --> 00:16:38,040 Speaker 1: chatting with the guy and I was like, so, what 278 00:16:38,040 --> 00:16:40,400 Speaker 1: do you do and he said, I'm a bariatric surgeon 279 00:16:40,480 --> 00:16:43,880 Speaker 1: and no kidding. And I was like, what, We're about 280 00:16:43,920 --> 00:16:46,040 Speaker 1: to do a podcast episode on that, and he said, 281 00:16:46,080 --> 00:16:51,360 Speaker 1: what's a podcast. I'm just said, well, what's a bariatric surgery? Now? 282 00:16:51,400 --> 00:16:52,920 Speaker 1: He didn't ask that because we had already talked a 283 00:16:52,960 --> 00:16:56,440 Speaker 1: little bit, but he uh, very nice guy from Texas 284 00:16:56,600 --> 00:16:59,920 Speaker 1: and he um talked a little bit. I didn't like 285 00:17:00,000 --> 00:17:02,360 Speaker 1: want to bother him too much about it, although he 286 00:17:02,440 --> 00:17:05,000 Speaker 1: really really enjoyed talking about it because he's not only 287 00:17:05,520 --> 00:17:09,879 Speaker 1: a bariatric surgeon, but he's very much a wellness doctor 288 00:17:09,920 --> 00:17:12,720 Speaker 1: and he believes that it's just part of a wellness 289 00:17:12,760 --> 00:17:15,640 Speaker 1: plan for your life. Um, not just like all right, 290 00:17:15,680 --> 00:17:19,000 Speaker 1: we'll do it and then have fun in the world. Um. 291 00:17:19,119 --> 00:17:20,399 Speaker 1: So he was a good guy to talk to you. 292 00:17:20,400 --> 00:17:23,840 Speaker 1: But he talked about sleeve gast direct Uh here there 293 00:17:23,840 --> 00:17:27,240 Speaker 1: I went again, sleeve gastro pub being the most popular 294 00:17:27,280 --> 00:17:30,520 Speaker 1: gastro pub. Yeah, it is the most popular gastro pub 295 00:17:30,560 --> 00:17:33,840 Speaker 1: of all time. So what how does that surgery go? Though? Um, 296 00:17:33,880 --> 00:17:37,760 Speaker 1: it's pretty quick for one Yeah, I think it's like 297 00:17:37,840 --> 00:17:40,679 Speaker 1: forty to seventy minutes, not that long. You stay in 298 00:17:40,680 --> 00:17:42,639 Speaker 1: the hospital for a couple of nights. They keep an 299 00:17:42,640 --> 00:17:44,320 Speaker 1: eye on you. And one of the reasons they're keeping 300 00:17:44,359 --> 00:17:47,040 Speaker 1: an eye on you is because for two weeks afterward, 301 00:17:47,600 --> 00:17:50,479 Speaker 1: you can have nothing but a liquid diet. Because if 302 00:17:50,560 --> 00:17:54,320 Speaker 1: you go look up sleeve gastrectomy videos, Um, there's a 303 00:17:54,359 --> 00:17:56,639 Speaker 1: lot of computer animations out there that show you what 304 00:17:56,680 --> 00:17:59,200 Speaker 1: they're doing, so you can imagine that if you remove 305 00:17:59,680 --> 00:18:05,040 Speaker 1: probably doably, I think maybe of your stomach um, it 306 00:18:05,080 --> 00:18:07,240 Speaker 1: needs to heal. And the way that you help at 307 00:18:07,240 --> 00:18:10,240 Speaker 1: heal over the first two weeks is by just drinking 308 00:18:10,320 --> 00:18:16,359 Speaker 1: like broth, water, um, maybe some gatorade if you're feeling spicy. Um. 309 00:18:16,400 --> 00:18:20,040 Speaker 1: But again, remember like you're not sitting there going bonkers 310 00:18:20,080 --> 00:18:23,280 Speaker 1: wanting food. Um. Most people who have a sleeve gets 311 00:18:23,359 --> 00:18:27,920 Speaker 1: tructomy report having to make themselves eat. They have to 312 00:18:28,040 --> 00:18:31,120 Speaker 1: keep a strict schedule because they don't want to eat 313 00:18:31,280 --> 00:18:35,240 Speaker 1: like they used to, like most people want to eat. Yeah, 314 00:18:35,240 --> 00:18:38,760 Speaker 1: And I mean we'll talk a little bit about maintenance later, 315 00:18:38,800 --> 00:18:42,280 Speaker 1: but I think in the end they recommend you eat like, 316 00:18:42,640 --> 00:18:45,040 Speaker 1: you know, four to six very small meals a day, 317 00:18:45,760 --> 00:18:47,800 Speaker 1: Like there's no way around it. You're you're going to 318 00:18:47,920 --> 00:18:52,040 Speaker 1: change you're eating habits in your lifestyle in a big, 319 00:18:52,080 --> 00:18:55,120 Speaker 1: big way if you have this surgery. And I read 320 00:18:55,160 --> 00:18:58,359 Speaker 1: a lot of first person accounts of like, you know, 321 00:18:58,440 --> 00:18:59,960 Speaker 1: can you ever go out to eat again and said 322 00:19:00,000 --> 00:19:02,480 Speaker 1: down with your family and enjoy a meal, because if 323 00:19:02,480 --> 00:19:05,000 Speaker 1: you're filling something the size of an egg, it's like 324 00:19:05,000 --> 00:19:07,640 Speaker 1: can you even order a meal? And you know, everyone 325 00:19:07,760 --> 00:19:10,359 Speaker 1: that I read was it's like, yeah, you know, you 326 00:19:10,359 --> 00:19:12,840 Speaker 1: you get used to it. You go to the restaurant, 327 00:19:13,320 --> 00:19:16,800 Speaker 1: you order an appetizer maybe, and you don't even eat 328 00:19:16,800 --> 00:19:18,840 Speaker 1: half of the appetizer and you take the rest home. 329 00:19:19,240 --> 00:19:22,119 Speaker 1: You do a lot more talking at dinner, and you 330 00:19:22,240 --> 00:19:25,400 Speaker 1: don't drink alcohol. You can't drink liquids while you eat 331 00:19:25,440 --> 00:19:28,920 Speaker 1: at all. Um, they're saying, you know, you drink liquids 332 00:19:29,359 --> 00:19:31,840 Speaker 1: no more than thirty minutes before you have a meal 333 00:19:32,119 --> 00:19:35,199 Speaker 1: because there's so little room. Uh. I did see some 334 00:19:35,240 --> 00:19:37,880 Speaker 1: people say they could drink a little alcohol, but it's 335 00:19:38,000 --> 00:19:41,840 Speaker 1: really recommended you basically quit drinking. Certainly, you don't want 336 00:19:41,880 --> 00:19:44,480 Speaker 1: to drink beer when you have a tiny egg stomach. God, 337 00:19:45,040 --> 00:19:47,919 Speaker 1: oh my god, that sounds terrible. It does, um, but 338 00:19:48,080 --> 00:19:51,399 Speaker 1: you there's no way around it. You are changing your lifestyle. 339 00:19:51,480 --> 00:19:54,080 Speaker 1: But across the board, when I read all these first 340 00:19:54,080 --> 00:19:56,480 Speaker 1: person accounts, everyone was like, you get used to it, 341 00:19:56,880 --> 00:20:00,360 Speaker 1: and the trade off is for them the they are 342 00:20:00,440 --> 00:20:04,360 Speaker 1: much healthier and happier and generally didn't have the regrets. 343 00:20:04,359 --> 00:20:07,640 Speaker 1: I'm sure you could find some people that had regrets 344 00:20:07,640 --> 00:20:09,720 Speaker 1: and were like, I missed sitting down and eating big 345 00:20:09,760 --> 00:20:13,120 Speaker 1: meals with my friends and family. But I mean, most 346 00:20:13,200 --> 00:20:15,040 Speaker 1: of the people that I read were pretty satisfied with 347 00:20:15,040 --> 00:20:18,800 Speaker 1: the surgery. So um, after you get surgery too, and 348 00:20:18,840 --> 00:20:21,320 Speaker 1: I can imagine they're satisfied because when you get a 349 00:20:21,359 --> 00:20:25,080 Speaker 1: sleeve guests trick to me UM, the doctors who performed 350 00:20:25,160 --> 00:20:28,240 Speaker 1: this these kind of procedures they use as something called 351 00:20:28,240 --> 00:20:31,840 Speaker 1: excess weight to qualify the success of the surgery. And 352 00:20:31,960 --> 00:20:35,159 Speaker 1: excess weight is the difference between your ideal weight and 353 00:20:35,480 --> 00:20:39,639 Speaker 1: what you weighed before the surgery and eighteen months after 354 00:20:39,960 --> 00:20:46,199 Speaker 1: the procedure, patients typically have lost about seventy percent of 355 00:20:46,600 --> 00:20:51,040 Speaker 1: their of their body weight after after the surgery. Within 356 00:20:51,080 --> 00:20:53,639 Speaker 1: a year and a half, their excess weight, right, Yes, 357 00:20:53,680 --> 00:20:57,200 Speaker 1: they're excess weight. Yeah, And you know, generally it's not 358 00:20:57,280 --> 00:21:01,879 Speaker 1: like uh, the days of your with gastric banding, which 359 00:21:01,920 --> 00:21:06,200 Speaker 1: has really gone out of favor, UM a lot of complications, 360 00:21:06,240 --> 00:21:09,080 Speaker 1: the weight generally did not stay off. But with sleeve 361 00:21:09,119 --> 00:21:12,720 Speaker 1: gastrectomy and then as we'll see with gastric bypass, the 362 00:21:12,760 --> 00:21:17,960 Speaker 1: weight does tend to stay off for years, although people 363 00:21:18,000 --> 00:21:21,040 Speaker 1: do gain some of the weight back. UM. One study 364 00:21:21,040 --> 00:21:24,400 Speaker 1: saw after twelve years about forty percent of patients had 365 00:21:24,480 --> 00:21:28,359 Speaker 1: maintained a thirty percent weight loss or more compared to 366 00:21:28,359 --> 00:21:32,280 Speaker 1: their original total weight, and where at least ten percent 367 00:21:32,359 --> 00:21:37,040 Speaker 1: lighter than they'd been. So sixty percent of people gain 368 00:21:37,119 --> 00:21:41,359 Speaker 1: back more than thirty percent of their weight. Is that 369 00:21:41,359 --> 00:21:43,800 Speaker 1: a way to say it? Yeah, I have to admit 370 00:21:43,840 --> 00:21:47,080 Speaker 1: you just made my brain do a somersault. But yes, 371 00:21:47,160 --> 00:21:50,200 Speaker 1: that's the that's the that's the converse, I guess. Huh. Yes, 372 00:21:50,240 --> 00:21:52,280 Speaker 1: So sixty percent of people gain back more than that 373 00:21:52,320 --> 00:21:55,040 Speaker 1: thirty percent, But it doesn't mean they gained all the 374 00:21:55,040 --> 00:21:58,919 Speaker 1: weight back that could have been. No, because again, like 375 00:21:58,960 --> 00:22:01,920 Speaker 1: you said, sent or at least ten percent lighter than 376 00:22:01,920 --> 00:22:05,800 Speaker 1: they've been before a lot of percentages flying around here. Yeah. So, 377 00:22:05,880 --> 00:22:08,840 Speaker 1: but the upshot is is that you are definitely going 378 00:22:08,880 --> 00:22:13,159 Speaker 1: to lose weight if you're a physician, UM, especially if 379 00:22:13,160 --> 00:22:16,919 Speaker 1: you're a bariatric surgeon. You consider bariatric surgery the gold 380 00:22:17,000 --> 00:22:23,200 Speaker 1: standard for rapid and sustained weight loss. That like, that's 381 00:22:23,560 --> 00:22:27,040 Speaker 1: if if you have a patient who is um like 382 00:22:27,359 --> 00:22:32,359 Speaker 1: again obese UM to a to like maybe say three 383 00:22:32,440 --> 00:22:36,280 Speaker 1: hundred four hundred pounds or more UM, you would say, look, 384 00:22:36,640 --> 00:22:39,359 Speaker 1: you really need the surgery and it's going to change 385 00:22:39,359 --> 00:22:41,600 Speaker 1: your life. It's you would probably also tell them it's 386 00:22:41,640 --> 00:22:44,280 Speaker 1: going to save their life too. Again, it's questionable, but 387 00:22:44,320 --> 00:22:47,639 Speaker 1: that's the medical stance, that's right. Uh. Then we have 388 00:22:47,720 --> 00:22:51,359 Speaker 1: the gastric bypass, the original rue on y or r 389 00:22:51,520 --> 00:22:55,880 Speaker 1: y GB surgery. Uh. They staple off part of your stomach. 390 00:22:56,400 --> 00:23:00,119 Speaker 1: They reduce that remaining part too. Again about this as 391 00:23:00,160 --> 00:23:02,720 Speaker 1: an egg, and then they attach it to that rue 392 00:23:02,800 --> 00:23:06,400 Speaker 1: lamb of the small intestine and you're you know, most 393 00:23:06,440 --> 00:23:09,040 Speaker 1: of that stomach and the upper small intestine is now bypass. 394 00:23:09,119 --> 00:23:12,400 Speaker 1: That's why they call it bypass surgery. And this one 395 00:23:12,520 --> 00:23:16,320 Speaker 1: is I think there are a few more complications now 396 00:23:17,560 --> 00:23:19,320 Speaker 1: and that's why this one's fallen out of favor a 397 00:23:19,320 --> 00:23:21,960 Speaker 1: little bit. Compared to sleeve guest struck to me, right, Yeah, 398 00:23:22,040 --> 00:23:24,199 Speaker 1: the impression I have is that sleeve gets struck to me, 399 00:23:24,320 --> 00:23:29,000 Speaker 1: is much more um or much less complicated afterward, because 400 00:23:29,560 --> 00:23:32,119 Speaker 1: you're not messing with the original plumbing. All you're doing 401 00:23:32,200 --> 00:23:35,400 Speaker 1: is removing a large section of the stomach. Everything else 402 00:23:35,440 --> 00:23:39,200 Speaker 1: remains as is, so you still have like a risk 403 00:23:39,240 --> 00:23:43,000 Speaker 1: of developing an infection or leakage in your stomach or 404 00:23:43,040 --> 00:23:47,560 Speaker 1: all sorts of stuff. UM, but you're not like bypassing, 405 00:23:47,600 --> 00:23:50,400 Speaker 1: you're not detaching the stomach and then reattaching it elsewhere, 406 00:23:50,440 --> 00:23:54,280 Speaker 1: which adds an entirely different dimension to that surgery. And 407 00:23:54,359 --> 00:23:57,760 Speaker 1: that's what ruined. Why is and when you're doing that, Chuck, 408 00:23:57,800 --> 00:24:00,600 Speaker 1: The reason why you're doing that, UM is because you're 409 00:24:01,240 --> 00:24:06,800 Speaker 1: you're basically, UM keeping the small intestine from being able 410 00:24:06,880 --> 00:24:11,400 Speaker 1: to digest as much like fats carbohydrates all that stuff 411 00:24:11,440 --> 00:24:13,720 Speaker 1: from the food you eat, so you're eating less, but 412 00:24:13,760 --> 00:24:16,840 Speaker 1: you're also digesting less of it or absorbing less of it, 413 00:24:17,240 --> 00:24:21,320 Speaker 1: so that leads to rapid weight loss as well. That's right. So, 414 00:24:21,680 --> 00:24:25,359 Speaker 1: like we said, as far as this being an effective thing, uh, 415 00:24:25,400 --> 00:24:29,440 Speaker 1: you know, losing weight for some people is really really 416 00:24:29,480 --> 00:24:32,760 Speaker 1: really hard. So for some people it is a mountain 417 00:24:32,840 --> 00:24:36,600 Speaker 1: that they cannot overcome. Uh, diets, you know, I think 418 00:24:36,640 --> 00:24:40,200 Speaker 1: the verdict is in across the board on diets, which 419 00:24:40,280 --> 00:24:43,520 Speaker 1: is diets are a quick fix and it's very hard 420 00:24:43,560 --> 00:24:47,960 Speaker 1: to keep that maintenance. Everybody basically agrees that UM, long 421 00:24:48,040 --> 00:24:52,119 Speaker 1: term weight loss involves life complete lifestyle change and not 422 00:24:52,359 --> 00:24:55,160 Speaker 1: some kind of crazy diet that you're doing, or even 423 00:24:55,160 --> 00:24:58,200 Speaker 1: not crazy diet that you're doing. UM. Exercise we've talked 424 00:24:58,200 --> 00:25:01,040 Speaker 1: about on the podcast is great for your body, but 425 00:25:01,560 --> 00:25:05,200 Speaker 1: you cannot exercise the weight off if you don't change 426 00:25:05,280 --> 00:25:10,200 Speaker 1: the food and drink portion of your life precisely. And 427 00:25:10,240 --> 00:25:13,560 Speaker 1: even even when you do diet like um, you you 428 00:25:13,640 --> 00:25:17,679 Speaker 1: may actually change your body so that you aren't able 429 00:25:17,840 --> 00:25:20,760 Speaker 1: to lose weight after a point, and when you stop dieting, 430 00:25:20,800 --> 00:25:24,080 Speaker 1: you may gain back more weight than before, So that 431 00:25:24,119 --> 00:25:27,400 Speaker 1: could be dangerous for sure. You don't want to mess 432 00:25:27,440 --> 00:25:30,240 Speaker 1: with your metabolism too much. Um and I would direct 433 00:25:30,320 --> 00:25:32,840 Speaker 1: people to our Intuitive Eating episode. We talked a lot 434 00:25:32,840 --> 00:25:36,920 Speaker 1: about that, but um that like that, Like you said, 435 00:25:36,920 --> 00:25:41,359 Speaker 1: the verdict being in on dieting has really kind of 436 00:25:41,480 --> 00:25:45,080 Speaker 1: supported the idea of bariatric surgery is not only the 437 00:25:45,119 --> 00:25:48,800 Speaker 1: gold standard but really the only real option you have 438 00:25:48,920 --> 00:25:51,160 Speaker 1: if you want to lose a serious amount of weight. 439 00:25:51,960 --> 00:25:54,679 Speaker 1: Um and so uh A lot of people have been 440 00:25:54,680 --> 00:25:58,159 Speaker 1: studying like just how how effective it is, and like 441 00:25:58,200 --> 00:26:01,640 Speaker 1: you said, um, you know, there's there's lots of percentages 442 00:26:01,640 --> 00:26:04,560 Speaker 1: flying around and how many people kept how much weight off, 443 00:26:04,600 --> 00:26:07,720 Speaker 1: But there was this one study that looked at people 444 00:26:07,720 --> 00:26:11,480 Speaker 1: who have gastric bypass surgery and contestants on the biggest 445 00:26:11,520 --> 00:26:14,520 Speaker 1: loser UM, which is a weight loss competition that's been 446 00:26:14,520 --> 00:26:18,639 Speaker 1: on TV forever UM and they use them because it's 447 00:26:18,680 --> 00:26:22,240 Speaker 1: hard to find a group of people who lose about 448 00:26:22,320 --> 00:26:24,600 Speaker 1: as much weight as you would lose with the gastric 449 00:26:24,640 --> 00:26:29,480 Speaker 1: bypass surgery UM, but without using gastric bypass surgery, So 450 00:26:29,520 --> 00:26:33,320 Speaker 1: they made like an ideal control group. That's right, uh, 451 00:26:33,359 --> 00:26:36,720 Speaker 1: And what they found is really super interesting. Both groups 452 00:26:37,280 --> 00:26:39,680 Speaker 1: lost about the same amount of weight, or at least 453 00:26:39,680 --> 00:26:44,400 Speaker 1: similar amounts. But the biggest loser group I hate even 454 00:26:44,440 --> 00:26:47,640 Speaker 1: saying that, I hate that dumb title. The biggest loser 455 00:26:47,640 --> 00:26:52,800 Speaker 1: group experience what's called metabolic adaptation, which is to say 456 00:26:52,840 --> 00:26:55,760 Speaker 1: that their metabolism slowed down and it made it harder 457 00:26:55,800 --> 00:26:58,680 Speaker 1: to keep that weight off. So six years on down 458 00:26:58,680 --> 00:27:02,239 Speaker 1: the road, that control group with the biggest loser uh 459 00:27:02,480 --> 00:27:05,960 Speaker 1: bunch had regained a lot of that weight, but their 460 00:27:06,000 --> 00:27:10,280 Speaker 1: metabolism was still really low uh and lower than and 461 00:27:10,440 --> 00:27:12,400 Speaker 1: slower than it was to begin with, So it kind 462 00:27:12,400 --> 00:27:15,760 Speaker 1: of permanently altered. It seems like I don't know about permanently, 463 00:27:15,760 --> 00:27:19,240 Speaker 1: but at least six years later had had altered their metabolism. 464 00:27:19,280 --> 00:27:21,600 Speaker 1: It's not permanent, no, but they will have to go 465 00:27:21,640 --> 00:27:26,240 Speaker 1: through the process of retraining their body to not store 466 00:27:26,280 --> 00:27:30,720 Speaker 1: as much fat or burn energy slower um in order 467 00:27:30,760 --> 00:27:34,240 Speaker 1: to get back to normal. But that's what dieting can 468 00:27:34,320 --> 00:27:37,840 Speaker 1: really do to you. But what happened with the other group, Well, 469 00:27:37,880 --> 00:27:42,440 Speaker 1: the other group, the bariatric surgery patients. They they're metabolism stabilized. 470 00:27:42,800 --> 00:27:45,520 Speaker 1: So there's a lot of rapid weight loss just because 471 00:27:45,560 --> 00:27:48,680 Speaker 1: you're you're taking in less, but also because your body 472 00:27:48,760 --> 00:27:51,800 Speaker 1: is not producing hunger hormones like growing and it may 473 00:27:51,880 --> 00:27:56,479 Speaker 1: actually actually produce more of the satiated um. Is that right? 474 00:27:56,520 --> 00:28:06,480 Speaker 1: Satiated satiety, sure, sitcom um sat safety hormone leapton so um, 475 00:28:06,520 --> 00:28:10,280 Speaker 1: they're metabolism. Actually, it just stabilized. So eventually they stopped 476 00:28:10,320 --> 00:28:13,399 Speaker 1: losing weight, maybe gained a little bit back, but typically 477 00:28:13,800 --> 00:28:16,280 Speaker 1: kind of hold um. What's what's referred to as a 478 00:28:16,320 --> 00:28:19,760 Speaker 1: baseline weight, basically the weight that your body and your 479 00:28:19,800 --> 00:28:22,359 Speaker 1: metabolism says, this is how much you should weigh. Try 480 00:28:22,520 --> 00:28:24,640 Speaker 1: as you will, we're always going to try to get 481 00:28:24,640 --> 00:28:26,760 Speaker 1: back to this, and if you mess with us, we're 482 00:28:26,760 --> 00:28:29,960 Speaker 1: gonna make it harder on you than ever, right, Which 483 00:28:30,000 --> 00:28:33,120 Speaker 1: I mean, that's study really makes a pretty good case 484 00:28:33,200 --> 00:28:37,120 Speaker 1: for bariatric surgery as an option for people. Right, Uh, 485 00:28:37,160 --> 00:28:41,320 Speaker 1: so does this There was a meta analysis in that 486 00:28:41,440 --> 00:28:45,280 Speaker 1: saw certain we talked earlier about, you know, health complications 487 00:28:45,320 --> 00:28:49,600 Speaker 1: from caring too much weight UM, that bariatric surgery reduces 488 00:28:50,720 --> 00:28:55,320 Speaker 1: the risk to develop type two diabetes by h and 489 00:28:55,440 --> 00:29:00,000 Speaker 1: hypertension by six and if you already had those conditions 490 00:29:00,080 --> 00:29:02,560 Speaker 1: going in, which can be one of the criteria to 491 00:29:02,600 --> 00:29:05,720 Speaker 1: get the surgery to begin with. Uh, the surgery was 492 00:29:05,760 --> 00:29:09,719 Speaker 1: associated with remission. Even so, just to take a little sidebar, 493 00:29:09,960 --> 00:29:13,160 Speaker 1: I didn't understand how people can say, okay, if you 494 00:29:13,320 --> 00:29:15,400 Speaker 1: if you have if you're faced with data like that, 495 00:29:15,680 --> 00:29:19,560 Speaker 1: how can you possibly say that obesity um is not 496 00:29:19,680 --> 00:29:23,360 Speaker 1: necessarily linked with poor health, or that there's a concept 497 00:29:23,360 --> 00:29:25,520 Speaker 1: called healthy at any size, which I want to do 498 00:29:25,560 --> 00:29:30,000 Speaker 1: an episode on eventually. UM. And the thing that I 499 00:29:30,040 --> 00:29:35,040 Speaker 1: saw the explanation is, yes, these things are associated with obesity, 500 00:29:35,120 --> 00:29:38,960 Speaker 1: with being overweight. But it's the point is is if 501 00:29:38,960 --> 00:29:42,360 Speaker 1: you're a b obese or overweight, you're not automatically going 502 00:29:42,360 --> 00:29:46,680 Speaker 1: to get type two diabetes, not automatically going to develop hypertension. 503 00:29:46,960 --> 00:29:50,000 Speaker 1: And in much the same way that smokers may or 504 00:29:50,120 --> 00:29:53,440 Speaker 1: may not develop lung cancer. People who are overweight or 505 00:29:53,480 --> 00:29:56,920 Speaker 1: obese may or may not develop type two diabetes or 506 00:29:57,040 --> 00:30:00,960 Speaker 1: hypertension or some of the other um maladies I guess 507 00:30:00,960 --> 00:30:05,040 Speaker 1: associated with being overweight by the medical establishment. Yeah, yeah, 508 00:30:05,040 --> 00:30:06,800 Speaker 1: it's a good way to look at it. Yeah, I 509 00:30:06,840 --> 00:30:09,840 Speaker 1: just wanted to add that. Sure, but Chuck, the thing 510 00:30:09,920 --> 00:30:12,400 Speaker 1: is it is it is evident that yes, if you 511 00:30:12,480 --> 00:30:17,840 Speaker 1: do have those maladies, Yeah, gastric bypass surgery bariatric surgery 512 00:30:18,040 --> 00:30:21,880 Speaker 1: will definitely help your health outcomes as a result. Yeah, 513 00:30:22,000 --> 00:30:25,360 Speaker 1: or headed toward those, And it's not like if you 514 00:30:25,400 --> 00:30:28,560 Speaker 1: get regular physicals, you know when you're headed toward those, 515 00:30:29,200 --> 00:30:32,240 Speaker 1: towards type two diabetes and hypertension. It's not like a 516 00:30:32,320 --> 00:30:34,520 Speaker 1: switch is just flicked and you're like, all right, I've 517 00:30:34,520 --> 00:30:38,120 Speaker 1: got those two conditions now, Like you know the blood 518 00:30:38,160 --> 00:30:40,400 Speaker 1: tests that they give you, and trust me, I've been 519 00:30:40,640 --> 00:30:42,720 Speaker 1: I go every year now, Like I want to know 520 00:30:42,800 --> 00:30:45,760 Speaker 1: about my body. I'm not one of these guys who 521 00:30:46,120 --> 00:30:48,320 Speaker 1: is overweight and like just buries my head in the sand, 522 00:30:48,920 --> 00:30:51,680 Speaker 1: probably to my detriment. Want to get too many tests 523 00:30:51,720 --> 00:30:54,080 Speaker 1: done and things like that, because I want to know 524 00:30:54,120 --> 00:30:57,960 Speaker 1: what's up. But you know, I've seen my own health 525 00:30:58,080 --> 00:31:01,280 Speaker 1: like creep up towards those numbers two levels that I 526 00:31:01,280 --> 00:31:03,560 Speaker 1: don't like, So then I have to work to like 527 00:31:03,720 --> 00:31:06,320 Speaker 1: get those numbers back down. And it's all it's all 528 00:31:06,400 --> 00:31:09,800 Speaker 1: data driven, and it's all from blood tests. And I 529 00:31:10,040 --> 00:31:13,680 Speaker 1: just encourage people to go get their physicals every year. 530 00:31:13,800 --> 00:31:17,480 Speaker 1: There's no I know people that bury their head in 531 00:31:17,520 --> 00:31:19,400 Speaker 1: the sand and are just like, I just don't want 532 00:31:19,400 --> 00:31:22,760 Speaker 1: to know about that stuff. And I just think people 533 00:31:22,800 --> 00:31:26,960 Speaker 1: should really be uh advocate for their own health and 534 00:31:26,960 --> 00:31:29,720 Speaker 1: and uh, what's the word I'm looking for when you 535 00:31:30,440 --> 00:31:34,480 Speaker 1: are just sort of preemptively um, sort of getting tests 536 00:31:34,480 --> 00:31:39,840 Speaker 1: to find out where you stand, you know, um taking action, Yeah, 537 00:31:39,920 --> 00:31:42,960 Speaker 1: well taking action on the medical side. Uh, so you 538 00:31:42,960 --> 00:31:46,160 Speaker 1: can take action you know at home. Yeah. It also 539 00:31:46,240 --> 00:31:47,880 Speaker 1: you know, you don't have to go to a doctor 540 00:31:47,920 --> 00:31:50,400 Speaker 1: to get blood tests. You can you can order your 541 00:31:50,400 --> 00:31:52,680 Speaker 1: own basically and just go to like quest or lab 542 00:31:52,720 --> 00:31:54,479 Speaker 1: Corps or something. Oh yeah, just like do your own 543 00:31:54,480 --> 00:31:56,960 Speaker 1: blood pail. Yeah yeah, and they have you know, the 544 00:31:57,040 --> 00:31:59,760 Speaker 1: results show if you're in like a normal range or 545 00:31:59,760 --> 00:32:02,440 Speaker 1: whatever over for everything. Yeah, or if you cut yourself, 546 00:32:02,760 --> 00:32:04,480 Speaker 1: squeeze a little bit on a piece of white paper 547 00:32:04,480 --> 00:32:06,520 Speaker 1: and just look at it for a while that's right, 548 00:32:06,600 --> 00:32:09,240 Speaker 1: what does it look like? It's like reading tea leaves 549 00:32:09,320 --> 00:32:12,200 Speaker 1: or chicken guts? Uh, what was I gonna say? Oh? 550 00:32:12,280 --> 00:32:14,760 Speaker 1: There they did. As far as the meta analysis another 551 00:32:14,800 --> 00:32:17,880 Speaker 1: study with that analysis, they found about half the people 552 00:32:18,400 --> 00:32:22,200 Speaker 1: with type two diabetes that had the surgery had enough 553 00:32:22,200 --> 00:32:25,160 Speaker 1: improvement that they could get off their medication. And that's 554 00:32:25,160 --> 00:32:29,840 Speaker 1: what remission basically is. It's sort of like you're always 555 00:32:29,880 --> 00:32:33,120 Speaker 1: an alcoholic even though you quit drinking, Like technically you're 556 00:32:33,160 --> 00:32:36,120 Speaker 1: still diabetic, but if it's in remission, that means you've 557 00:32:36,160 --> 00:32:38,360 Speaker 1: gotten your numbers down to a safe level, you can 558 00:32:38,400 --> 00:32:42,200 Speaker 1: get off the medication and stuff like that. So um. Also, 559 00:32:42,280 --> 00:32:44,800 Speaker 1: by the way, there's that's questionable as well as whether 560 00:32:44,840 --> 00:32:49,120 Speaker 1: you're still an alcoholic after you quit drinking. Well is it? Yeah? 561 00:32:49,160 --> 00:32:52,000 Speaker 1: I mean it's sort of just terminology though right, No, 562 00:32:52,080 --> 00:32:54,760 Speaker 1: not necessarily. I think there's a there's definitely a school 563 00:32:54,840 --> 00:32:57,800 Speaker 1: thought that's that's once an addict, always an addict, Like 564 00:32:57,880 --> 00:33:00,600 Speaker 1: you will always be addicted. Even if you for the 565 00:33:00,600 --> 00:33:03,360 Speaker 1: rest of your life fifties sixty seventy years without ever 566 00:33:03,400 --> 00:33:06,720 Speaker 1: taking another drink, you'll always be an alcoholic. Other people say, no, 567 00:33:06,880 --> 00:33:09,440 Speaker 1: that's that's not true, And that's a whole mindset that 568 00:33:09,840 --> 00:33:13,040 Speaker 1: keeps people trapped in this idea that they're addicted or 569 00:33:13,040 --> 00:33:15,640 Speaker 1: an alcoholic when they aren't any longer, and it produces 570 00:33:15,680 --> 00:33:18,440 Speaker 1: a lot of unnecessary shame and hardship. You know. I'm 571 00:33:18,440 --> 00:33:20,920 Speaker 1: glad to hear that because I always thought that was 572 00:33:21,080 --> 00:33:25,160 Speaker 1: weird when someone who like quit drinking twenty years ago says, 573 00:33:25,600 --> 00:33:29,520 Speaker 1: I'm still an alcoholic, And I just thought that's not 574 00:33:29,680 --> 00:33:32,800 Speaker 1: for me to judge, Like that's their terminology that they 575 00:33:32,840 --> 00:33:34,800 Speaker 1: need to use. But I always thought that was a 576 00:33:34,840 --> 00:33:37,920 Speaker 1: strange way to think about it. So, but I think 577 00:33:37,920 --> 00:33:40,760 Speaker 1: that does apply for some people. I'm not saying for 578 00:33:40,840 --> 00:33:45,400 Speaker 1: all people. Yeah, it's just the opposite is true as well. Um, 579 00:33:45,640 --> 00:33:48,160 Speaker 1: just because you're an alcoholic, it doesn't mean you're always 580 00:33:48,240 --> 00:33:52,600 Speaker 1: going to be an alcoholic for everybody. Okay, I got you, so, 581 00:33:52,800 --> 00:33:55,880 Speaker 1: chuck chuck chuck. Yes, I say we take a break. 582 00:33:56,480 --> 00:33:58,600 Speaker 1: All right, let's do it. I'm gonna go into remission 583 00:33:58,600 --> 00:34:28,200 Speaker 1: and use the restroom. All right, we're back. I'm glad 584 00:34:28,200 --> 00:34:31,319 Speaker 1: we cleared that up about alcoholism. Yeah, I didn't know 585 00:34:31,360 --> 00:34:33,399 Speaker 1: that that was going to pop up. I didn't either, 586 00:34:33,400 --> 00:34:36,479 Speaker 1: And I'm glad you said something though, that's that's good information. Yeah, 587 00:34:36,719 --> 00:34:40,520 Speaker 1: I might say it stuff you should know. I just 588 00:34:40,600 --> 00:34:42,479 Speaker 1: used the line that I hate that everyone else uses 589 00:34:42,480 --> 00:34:44,240 Speaker 1: when you first meet them and tell them what you do. 590 00:34:44,960 --> 00:34:47,440 Speaker 1: Oh yeah, at some point when you meet someone new 591 00:34:47,480 --> 00:34:48,480 Speaker 1: and you tell what you do in the name of 592 00:34:48,480 --> 00:34:50,120 Speaker 1: the show, at some point they say, oh, that sounds 593 00:34:50,160 --> 00:34:52,680 Speaker 1: like stuff you should know. Right, Yeah, they definitely do, 594 00:34:52,920 --> 00:34:55,000 Speaker 1: or they'll hit you with So tell me something I 595 00:34:55,000 --> 00:35:00,640 Speaker 1: should know. Yeah. I also realized just this week why 596 00:35:00,719 --> 00:35:04,880 Speaker 1: some people who right in abbreviate the show s U 597 00:35:05,120 --> 00:35:08,440 Speaker 1: s K. I've never understood what they were doing. I 598 00:35:08,600 --> 00:35:10,920 Speaker 1: finally noticed the why and the you are next to 599 00:35:10,920 --> 00:35:13,600 Speaker 1: each other on the keyboard on a querity keyboard. Oh 600 00:35:13,640 --> 00:35:15,680 Speaker 1: you think that's what it is. It's got it's got 601 00:35:15,680 --> 00:35:18,120 Speaker 1: to be. I just figured people were doing the Prince 602 00:35:18,200 --> 00:35:23,160 Speaker 1: thing or just you know, internet shorthand for you as 603 00:35:23,239 --> 00:35:26,359 Speaker 1: you right, But it doesn't make Oh yeah, I guess 604 00:35:26,360 --> 00:35:30,160 Speaker 1: it does. It does. Okay, Well, maybe back in the 605 00:35:30,200 --> 00:35:35,080 Speaker 1: wilderness as much as I was before. Um, let's talk 606 00:35:35,080 --> 00:35:41,880 Speaker 1: about some risk factors. You did talk about leakage always is, 607 00:35:42,000 --> 00:35:44,239 Speaker 1: you know, just with any kind of abdominal surgery, you 608 00:35:44,320 --> 00:35:50,720 Speaker 1: might get there's a risk of infection and clotting, hernia, ulcer, gallstones, 609 00:35:51,719 --> 00:35:54,960 Speaker 1: botwel obstructions. I think most I think you find more 610 00:35:55,000 --> 00:35:59,640 Speaker 1: of those specific ones in the gastric bypass rather than 611 00:35:59,680 --> 00:36:03,120 Speaker 1: the sleep eve and then explain to everyone with these 612 00:36:03,200 --> 00:36:06,600 Speaker 1: two great words together mean dumping syndrome one of the 613 00:36:06,600 --> 00:36:11,040 Speaker 1: most unfortunately named medical conditions that has ever been put. 614 00:36:11,239 --> 00:36:15,560 Speaker 1: I think so dumping syndrome is where you basically um, 615 00:36:15,600 --> 00:36:20,480 Speaker 1: when you're eating after gastric bypass surgery or bariatric surgery. UM, 616 00:36:20,520 --> 00:36:22,719 Speaker 1: the food just moves out of your stomach too quick. 617 00:36:23,440 --> 00:36:26,560 Speaker 1: It's not it's not predigested enough, so when it hits 618 00:36:26,600 --> 00:36:31,320 Speaker 1: your um guts, it causes cramps, it can cause diarrhea. 619 00:36:31,360 --> 00:36:34,880 Speaker 1: There's another variation called late dumping syndrome, where if you 620 00:36:34,920 --> 00:36:41,040 Speaker 1: eat a an overly sugary meal or snack or whatever, um, 621 00:36:41,080 --> 00:36:44,560 Speaker 1: it can drop your blood sugar precipitously because so much 622 00:36:44,600 --> 00:36:48,359 Speaker 1: insulin gets released because again it wasn't predigested or pre 623 00:36:48,440 --> 00:36:52,000 Speaker 1: absorbed in any way. It just kind of shows up 624 00:36:52,000 --> 00:36:53,839 Speaker 1: in your gut like here, I am, I'm a bite 625 00:36:53,880 --> 00:36:56,840 Speaker 1: of steak. Let's see what we can do. Yeah, the 626 00:36:56,840 --> 00:37:02,120 Speaker 1: other thing you're gonna have to do is potentially takes supplements. Uh, 627 00:37:02,280 --> 00:37:05,560 Speaker 1: you know, just because you're eating so little, you're also 628 00:37:05,600 --> 00:37:09,919 Speaker 1: getting a fewer um good things into your body. And 629 00:37:10,080 --> 00:37:12,840 Speaker 1: you know, hopefully you're eating good things if you continue 630 00:37:12,840 --> 00:37:15,919 Speaker 1: to eat just very small amounts of bad stuff. And 631 00:37:15,960 --> 00:37:19,439 Speaker 1: again we're using scare quotes, but you know, if if 632 00:37:19,480 --> 00:37:21,640 Speaker 1: I get this and I continue just to eat fried 633 00:37:21,680 --> 00:37:24,880 Speaker 1: chicken and mashed potatoes, then I'm not giving my body 634 00:37:24,920 --> 00:37:28,160 Speaker 1: the nutrients that it needs, and you might need to 635 00:37:28,160 --> 00:37:31,000 Speaker 1: take supplements. One thing you definitely have to do is 636 00:37:31,360 --> 00:37:36,000 Speaker 1: eat really really slow and chew like you've never chewed before. Yeah, 637 00:37:36,040 --> 00:37:39,279 Speaker 1: you gotta chew like um, Dr Kellogg. Yeah, I mean 638 00:37:39,320 --> 00:37:43,600 Speaker 1: I think you're essentially trying to trick your body into 639 00:37:43,640 --> 00:37:47,160 Speaker 1: thinking you're on sort of a liquid diet. Still. Yeah, 640 00:37:47,280 --> 00:37:50,360 Speaker 1: but I think also your body is sending you signals 641 00:37:50,400 --> 00:37:53,440 Speaker 1: like please please stop. The three bites of steak is 642 00:37:53,480 --> 00:37:56,800 Speaker 1: too much, you know, like it's sending you those signals. 643 00:37:56,800 --> 00:37:59,200 Speaker 1: So you're you, Yeah, And I think it's from what 644 00:37:59,239 --> 00:38:04,360 Speaker 1: I understand, take some um some working out on figuring 645 00:38:04,360 --> 00:38:08,719 Speaker 1: out how to eat under this new under these new circumstances. 646 00:38:08,760 --> 00:38:10,480 Speaker 1: It's a little bit of trial and error, but that 647 00:38:10,600 --> 00:38:12,719 Speaker 1: people you know, work it out over time. I bet 648 00:38:12,800 --> 00:38:20,600 Speaker 1: you really appreciate food. Yeah, I could see that being, uh, 649 00:38:20,760 --> 00:38:24,400 Speaker 1: an effect of it. I could also see becoming totally 650 00:38:24,440 --> 00:38:27,799 Speaker 1: neutral towards food being in effect of it as well. Yeah. 651 00:38:27,840 --> 00:38:31,040 Speaker 1: I mean they're definitely psychological impacts. And that is played 652 00:38:31,040 --> 00:38:34,040 Speaker 1: out with another interesting side effect, which is and I 653 00:38:34,040 --> 00:38:38,000 Speaker 1: saw this in a few places, is that you are 654 00:38:38,280 --> 00:38:42,040 Speaker 1: more likely to get divorced then if you didn't have 655 00:38:42,120 --> 00:38:45,040 Speaker 1: the surgery. And I think there was one study. There's 656 00:38:45,040 --> 00:38:47,279 Speaker 1: been plenty of studies, but there was one that found 657 00:38:47,360 --> 00:38:51,800 Speaker 1: nine got divorced after the surgery compared to six percent 658 00:38:52,480 --> 00:38:55,080 Speaker 1: of the control group. And there are a lot of 659 00:38:55,080 --> 00:38:58,360 Speaker 1: ways to look at that one. Certainly is it it? Uh? 660 00:38:58,520 --> 00:39:02,080 Speaker 1: Maybe you have the increased confidence to leave a relationship 661 00:39:02,120 --> 00:39:04,480 Speaker 1: you didn't have the confidence lead before that you should 662 00:39:04,480 --> 00:39:09,240 Speaker 1: have leaved, like a bad relationship. Apparently you get married 663 00:39:09,400 --> 00:39:13,200 Speaker 1: or in a relationship more if after you get the surgery, 664 00:39:13,239 --> 00:39:16,279 Speaker 1: which also could make a lot of sense. Yeah, which 665 00:39:16,320 --> 00:39:18,320 Speaker 1: is nice. I like that one. That's the silver lining 666 00:39:18,320 --> 00:39:21,520 Speaker 1: to the other cloud. You know. Um so if you 667 00:39:21,600 --> 00:39:25,560 Speaker 1: if you said, okay, what about me, how do I 668 00:39:25,600 --> 00:39:28,600 Speaker 1: know if I qualify for bariatric surgery, because I don't 669 00:39:28,600 --> 00:39:31,560 Speaker 1: know if we said or not, chuck. Um insurance will 670 00:39:31,640 --> 00:39:34,879 Speaker 1: cover it, Medicaid, Medicare, and private insurance will cover under 671 00:39:34,920 --> 00:39:39,480 Speaker 1: certain circumstances. Because again, obesity has been medicalized and is 672 00:39:39,560 --> 00:39:45,360 Speaker 1: this is seen as a disease or um a syndrome 673 00:39:45,600 --> 00:39:49,160 Speaker 1: or symptom of disease right or associated with disease, if 674 00:39:49,200 --> 00:39:51,879 Speaker 1: not a disease itself. So they've said, okay, we'll cover 675 00:39:51,960 --> 00:39:53,960 Speaker 1: this if you have a b m I of at 676 00:39:54,040 --> 00:39:56,960 Speaker 1: least forty or you're more than a hundred pounds overweight. 677 00:39:57,320 --> 00:39:59,759 Speaker 1: I was surprised it was just a hundred pounds. I 678 00:40:00,000 --> 00:40:02,719 Speaker 1: it have thought it would be more than that. Yeah, um, 679 00:40:02,840 --> 00:40:04,240 Speaker 1: Or if you have a b m I of thirty 680 00:40:04,239 --> 00:40:07,480 Speaker 1: five and you also have type two diabetes or sleep 681 00:40:07,480 --> 00:40:12,520 Speaker 1: apnea or hypertension or fatty liver disease, it's not from alcohol, 682 00:40:13,200 --> 00:40:19,680 Speaker 1: uh osteo arthritis, lipid abnormalities, heart disease, or gastro intestinal 683 00:40:19,719 --> 00:40:24,080 Speaker 1: disorders gastro pub disorders along with that thirty b m I. 684 00:40:24,360 --> 00:40:29,240 Speaker 1: Or if you have tried to lose weight with several 685 00:40:29,360 --> 00:40:33,200 Speaker 1: multiple efforts and are unable to UM and I think 686 00:40:33,200 --> 00:40:36,400 Speaker 1: that's included with the b M I right, yes, yeah, 687 00:40:36,560 --> 00:40:39,640 Speaker 1: and that's actually I mean, they'll they insurance companies will 688 00:40:39,920 --> 00:40:41,520 Speaker 1: make you jump through a lot of hoops, and one 689 00:40:41,560 --> 00:40:44,839 Speaker 1: of them is, um, you need to try to lose 690 00:40:44,880 --> 00:40:47,759 Speaker 1: weight and show that you can't before they'll ensure you. 691 00:40:47,840 --> 00:40:50,360 Speaker 1: In some cases, there's a lot of meanness to it. 692 00:40:50,400 --> 00:40:54,120 Speaker 1: Really if you step back and think, like, um, that 693 00:40:54,320 --> 00:40:56,480 Speaker 1: like that you're treating somebody like that, not because of 694 00:40:56,480 --> 00:41:00,160 Speaker 1: any medical condition, but because they're overweight. Um. But that's 695 00:41:00,160 --> 00:41:02,279 Speaker 1: that's what insurance companies do to get to pay for it. 696 00:41:02,280 --> 00:41:05,120 Speaker 1: And if you pay for it yourself. Roxane Gaye got 697 00:41:05,200 --> 00:41:07,799 Speaker 1: it done and wrote an essay about it, and she 698 00:41:07,880 --> 00:41:10,160 Speaker 1: said that she paid out of pocket because she didn't 699 00:41:10,160 --> 00:41:12,200 Speaker 1: want to have to jump through any hoops or red tape, 700 00:41:12,680 --> 00:41:15,279 Speaker 1: and she said that the cost was breathtaking, as she 701 00:41:15,360 --> 00:41:18,280 Speaker 1: put it, really so yes, I would get the impression 702 00:41:18,280 --> 00:41:20,240 Speaker 1: that the average person would not be able to afford 703 00:41:20,239 --> 00:41:22,279 Speaker 1: it out of pockets. So there are hoops you're gonna 704 00:41:22,320 --> 00:41:26,720 Speaker 1: have to jump through. Apparently, according to paper by Boston 705 00:41:26,800 --> 00:41:30,560 Speaker 1: Medical Center, UM, fewer than one percent of patients, like 706 00:41:30,600 --> 00:41:34,040 Speaker 1: we said, get the surgery that qualify and one of 707 00:41:34,040 --> 00:41:37,600 Speaker 1: the big reasons is a lot of physicians PCPs still 708 00:41:37,640 --> 00:41:40,879 Speaker 1: do not recommend it. Apparently you were five times more 709 00:41:40,920 --> 00:41:42,960 Speaker 1: likely to get it if it is recommended by your 710 00:41:43,480 --> 00:41:47,719 Speaker 1: primary care physician, but it just doesn't happen as much. Yeah, 711 00:41:47,719 --> 00:41:49,919 Speaker 1: And I think, um, a lot of the PCPs aren't 712 00:41:50,000 --> 00:41:52,160 Speaker 1: up on the advances that have been made in things 713 00:41:52,200 --> 00:41:55,000 Speaker 1: like mortality rates and the fact that it's moved over 714 00:41:55,040 --> 00:41:58,240 Speaker 1: to laparoscopic. So if you get like kind of old 715 00:41:58,320 --> 00:42:01,520 Speaker 1: and said in their ways a married care physician, they 716 00:42:01,600 --> 00:42:04,560 Speaker 1: might not know that bariatric surgery is much safer than 717 00:42:04,600 --> 00:42:07,759 Speaker 1: it used to be and you know, much less invasive. 718 00:42:08,400 --> 00:42:10,520 Speaker 1: Um like here, just have a sody pop and it'll 719 00:42:10,560 --> 00:42:14,680 Speaker 1: be fine. Exactly, have a diet coke. Um. So if 720 00:42:14,680 --> 00:42:17,920 Speaker 1: you if you do get bariatric surgery, there's a chance, 721 00:42:17,960 --> 00:42:20,759 Speaker 1: an eight percent chance that you are a woman. Right, 722 00:42:21,480 --> 00:42:25,879 Speaker 1: That's right. Even though um obcit rates are the same 723 00:42:25,920 --> 00:42:27,719 Speaker 1: for men and women, women are way more likely to 724 00:42:27,719 --> 00:42:31,920 Speaker 1: get the surgery. Also, when women get the surgery compared 725 00:42:31,960 --> 00:42:36,120 Speaker 1: to men, they are younger than their male counterparts. And 726 00:42:36,719 --> 00:42:41,359 Speaker 1: I think that it's more like referrals. You're more likely 727 00:42:41,400 --> 00:42:44,279 Speaker 1: to get the surgery because you've been referred by someone 728 00:42:44,320 --> 00:42:48,160 Speaker 1: who got it rather than coming from your doctor. Uh. 729 00:42:48,200 --> 00:42:51,080 Speaker 1: And it also shows that women in this is sad 730 00:42:51,120 --> 00:42:54,760 Speaker 1: and and not surprising at all that of women listed 731 00:42:55,000 --> 00:42:59,719 Speaker 1: psychosocial concerns as one of their biggest motivations, even over 732 00:43:00,200 --> 00:43:06,080 Speaker 1: related concerns. Yes, but um uh. Infertility has also been 733 00:43:06,120 --> 00:43:10,000 Speaker 1: strongly linked as far as I understand, to um being 734 00:43:10,040 --> 00:43:13,640 Speaker 1: overweight or obese. So it's possible that some of the 735 00:43:13,719 --> 00:43:17,400 Speaker 1: increase in women who get it, or the disproportion of 736 00:43:17,440 --> 00:43:19,759 Speaker 1: women who get it, could be because they're seeking to 737 00:43:19,840 --> 00:43:24,200 Speaker 1: have a family or have an easier pregnancy too. Right. 738 00:43:24,520 --> 00:43:29,600 Speaker 1: And again on the sort of general shaming outlook of 739 00:43:29,600 --> 00:43:32,120 Speaker 1: this surgery, there was a survey about five years ago 740 00:43:32,640 --> 00:43:36,200 Speaker 1: in a poll I guess that in the US, um 741 00:43:36,200 --> 00:43:40,839 Speaker 1: almost people responded that bariatric surgery was the easy way 742 00:43:40,880 --> 00:43:45,520 Speaker 1: out rather than just like losing weight the old fashioned way. Yeah, 743 00:43:45,560 --> 00:43:49,040 Speaker 1: because that's and that's just so that's such a crock 744 00:43:49,200 --> 00:43:51,319 Speaker 1: because it's like, hey, you should really lose a bunch 745 00:43:51,360 --> 00:43:53,920 Speaker 1: of weight. Oh you're getting bariatric surgery. That's the easy 746 00:43:53,920 --> 00:43:58,640 Speaker 1: way out. And that really underscores how much people look 747 00:43:58,719 --> 00:44:03,480 Speaker 1: at being overweight as an individual moral failing that there 748 00:44:03,600 --> 00:44:06,200 Speaker 1: is ah, there's something wrong with you, yeah, or a 749 00:44:06,280 --> 00:44:10,560 Speaker 1: choice um or um that you just you're just lazy 750 00:44:10,719 --> 00:44:13,759 Speaker 1: or you just can't help yourself, whatever, so much so 751 00:44:13,840 --> 00:44:16,120 Speaker 1: that that just people who are overweight or obese or 752 00:44:16,200 --> 00:44:18,359 Speaker 1: just look down upon. They don't they're not treated with 753 00:44:18,400 --> 00:44:21,000 Speaker 1: the same kind of dignity that an average sized person 754 00:44:21,040 --> 00:44:24,120 Speaker 1: would be. And this actually shows up in medical settings too. 755 00:44:24,320 --> 00:44:29,680 Speaker 1: Apparently doctors um will not pay as much attention to 756 00:44:29,880 --> 00:44:35,280 Speaker 1: health indicators like UM cholesterol level or UM glucost levels 757 00:44:35,320 --> 00:44:38,680 Speaker 1: or whatever um, and instead just pay attention to the 758 00:44:38,719 --> 00:44:42,560 Speaker 1: appearance of an overweight or obese patient when they recommend 759 00:44:42,719 --> 00:44:46,040 Speaker 1: gastric bypass or bariatric surgery. So they're it's they're not 760 00:44:46,120 --> 00:44:50,640 Speaker 1: saying it's because you're hypertense or because you have diabetes. 761 00:44:50,840 --> 00:44:55,160 Speaker 1: They're essentially saying it's strictly because you're overweight. Yeah, and 762 00:44:55,600 --> 00:44:59,400 Speaker 1: sort of. The one thing that's obvious to me is 763 00:45:00,040 --> 00:45:03,080 Speaker 1: everything that I've seen about the surgery, the recovery, your 764 00:45:03,120 --> 00:45:06,040 Speaker 1: lifestyle afterward for the rest of your life. There's nothing 765 00:45:06,080 --> 00:45:08,960 Speaker 1: easy about it. It is not the easy way out. 766 00:45:09,000 --> 00:45:11,239 Speaker 1: It's not like, well, it's a forty minute surgery, then 767 00:45:11,239 --> 00:45:14,160 Speaker 1: you're good to go. It's it's not an easy thing 768 00:45:14,239 --> 00:45:17,360 Speaker 1: and it is a not something to go into lightly. 769 00:45:17,440 --> 00:45:21,360 Speaker 1: It is a major surgery that will completely alter the 770 00:45:21,440 --> 00:45:24,359 Speaker 1: way you eat, and a lot of people the way 771 00:45:24,400 --> 00:45:26,400 Speaker 1: they eat is a big part of their lifestyle in 772 00:45:26,440 --> 00:45:29,480 Speaker 1: their life and it will alter that forever. And it's 773 00:45:29,520 --> 00:45:33,200 Speaker 1: a big, huge, monumental change and there's nothing easy about it. 774 00:45:33,760 --> 00:45:38,439 Speaker 1: But it is your decision. It's up to you. UM. 775 00:45:38,480 --> 00:45:43,800 Speaker 1: From what I've seen about the fat positive activist community, UM, 776 00:45:44,000 --> 00:45:47,319 Speaker 1: they would probably recommend that you reflect on exactly why 777 00:45:47,400 --> 00:45:50,520 Speaker 1: you want the surgery. Is it because you are being 778 00:45:50,520 --> 00:45:55,000 Speaker 1: pressured by family, friends, society, um? Or is it just 779 00:45:55,400 --> 00:45:59,160 Speaker 1: for whatever reason? And whatever reason you have, it's your again, 780 00:45:59,200 --> 00:46:01,600 Speaker 1: it's your decision. No one can tell you that it's 781 00:46:01,680 --> 00:46:05,040 Speaker 1: right or wrong, but you should definitely educate yourself on 782 00:46:05,440 --> 00:46:08,279 Speaker 1: you know, the risks and the benefits and everything about it, 783 00:46:08,480 --> 00:46:10,719 Speaker 1: and then just make your decision and feel good about 784 00:46:10,719 --> 00:46:14,920 Speaker 1: it either way. Yeah. I agree. I hope this. Uh. 785 00:46:15,360 --> 00:46:17,520 Speaker 1: I think this is like one of those topics that 786 00:46:18,280 --> 00:46:20,799 Speaker 1: you know, people might research, you know, late at night 787 00:46:21,000 --> 00:46:23,600 Speaker 1: even and feeling shamed to even look into this kind 788 00:46:23,600 --> 00:46:26,200 Speaker 1: of procedure and hopefully we could clear up some of 789 00:46:26,200 --> 00:46:29,040 Speaker 1: this stuff and if if something people feel good about, 790 00:46:29,080 --> 00:46:30,799 Speaker 1: then they can own it and move forward with their 791 00:46:30,880 --> 00:46:34,520 Speaker 1: head held high. Very nice. You got anything else? I 792 00:46:34,600 --> 00:46:37,719 Speaker 1: got nothing else. Well, since Chuck said he's got nothing else, 793 00:46:37,719 --> 00:46:39,680 Speaker 1: that of course means it's time for a listener mail. 794 00:46:42,640 --> 00:46:46,400 Speaker 1: I'm gonna call this just a new listener from Canada. 795 00:46:47,120 --> 00:46:49,719 Speaker 1: I don't think that's how they see it. I'm a 796 00:46:49,760 --> 00:46:51,520 Speaker 1: new listener. Just want to say how much I enjoy 797 00:46:51,600 --> 00:46:54,319 Speaker 1: the show. My husband told me about stuff you should know, 798 00:46:54,880 --> 00:46:56,799 Speaker 1: and I kind of brushed them off, thinking this was 799 00:46:56,840 --> 00:46:59,879 Speaker 1: just another boring podcast trying to teach me boring thing. 800 00:47:00,719 --> 00:47:02,480 Speaker 1: But I finally gave it a shot and was hooked. 801 00:47:02,840 --> 00:47:05,359 Speaker 1: After the very first show I listened to you guys 802 00:47:05,360 --> 00:47:07,440 Speaker 1: have great chemistry, and I heard another listener call you 803 00:47:07,520 --> 00:47:11,040 Speaker 1: burten Ernie type of burten Ernie type. I feel that 804 00:47:12,160 --> 00:47:15,160 Speaker 1: I'll take that you have a great mix of random 805 00:47:15,160 --> 00:47:18,000 Speaker 1: knowledge and important knowledge, and I'll love your true crime 806 00:47:18,040 --> 00:47:21,000 Speaker 1: episodes to hope you keep going forever. And you should 807 00:47:21,040 --> 00:47:23,200 Speaker 1: know my husband is not letting me live this down 808 00:47:23,640 --> 00:47:26,640 Speaker 1: that he is the greatest podcast taste that is. From 809 00:47:26,680 --> 00:47:32,400 Speaker 1: Autumn in the Thunder Bay, Ontario, Canada, North America. Planet 810 00:47:32,400 --> 00:47:35,080 Speaker 1: Earth very nice thought them. Thank you very much, and 811 00:47:35,440 --> 00:47:37,960 Speaker 1: we're glad that you're with us, even though it was 812 00:47:38,080 --> 00:47:41,759 Speaker 1: your husband who made you do it. That's right. If 813 00:47:41,760 --> 00:47:43,399 Speaker 1: you want to be like Autumn and get in touch 814 00:47:43,440 --> 00:47:45,759 Speaker 1: with us, we would love that you can send us 815 00:47:45,760 --> 00:47:47,920 Speaker 1: an email. That's the best way to do it. Just 816 00:47:48,040 --> 00:47:50,560 Speaker 1: wrap it up, spank it on the bottom lightly, and 817 00:47:50,680 --> 00:47:57,000 Speaker 1: send it off to Stuff Podcasts at iHeart radio dot com. 818 00:47:57,120 --> 00:47:59,880 Speaker 1: Stuff you Should Know is a production of I heart Radio. 819 00:48:00,000 --> 00:48:02,399 Speaker 1: For more podcasts my heart Radio, visit the i heart 820 00:48:02,480 --> 00:48:05,400 Speaker 1: Radio app, Apple Podcasts, or wherever you listen to your 821 00:48:05,400 --> 00:48:12,759 Speaker 1: favorite shows. H m hm